Bridging the gap in health services for refugees in Tarrant County

More than 1,500 refugees move to Tarrant County each year. They come here from all over the world - places like Iraq, Somalia and Bhutan - to escape traumatic situations. Many have spent years in refugee camps where they had little or no opportunities. They come to the United States for better lives, but once they get here, they can meet new challenges including different languages, a tough job market and navigating an unfamiliar health care system.

Amy Raines-Milenkov, MPH, DrPH, assistant professor of Obstetrics and Gynecology, is leading a community-based research project, the Building Bridges Initiative, that aims to fill gaps in social services available to these refugees in Tarrant County.

Through the U.S.'s resettlement program, refugees are placed in Tarrant County, and with the help of resettlement agencies they receive services including Medicaid, job assistance, language assistance and case management for health services for about eight months. After that, they face these challenges on their own. That's where the Building Bridges Initiative comes in.

Building Bridges trains a diverse group of refugee women as community health workers so they can advocate for their communities. Raines-Milenkov and the first class of five workers - from Iraq, Somalia, Burma and Bhutan - conducted a series of focus groups with refugee women to pinpoint where health and social services can be improved and how refugees can better connect with what's available.

The first round of focus groups found that many refugee women have trouble getting help with health issues including reproductive and women's health, diabetes and depression, and learning how to navigate the U.S. health care system. The stress of economic instability, living in a strange new environment and not knowing the culture or the language underpin these concerns.

After compiling the focus group findings, Building Bridges developed educational programs focused on refugees who no longer receive case management from resettlement agencies. Building Bridges holds informational meetings with large groups of refugees from various countries and subjects of interest, and it explains how to apply for and maintain health services.

Throughout the project, the goal is to prove that the community health worker model is sustainable and to get other health organizations to adopt it.

By expanding community-based research projects like Building Bridges, Raines-Milenkov says the UNT Health Science Center's Obstetrics and Gynecology Department will create better health outcomes for women in the community.